#OTalk 20th October 2020 – Application of Theory to Occupational Therapy Practice, during Practice Placements – a current debate.

Hi, my name is Emma Spellman (OTEmmaS @EmmaspellmanOT) and I have been an occupational therapist for over 24 years. During my student years, practitioner years and now as an academic I have heard stories from students, practice educators and academics about the challenges occupational therapy students have when trying to apply theory to practice. This application is especially important for the purposes of preparing for, using during and reflecting upon post practice placements. Is this something that is commonly discussed within our occupational therapy profession?

Below I have outlined the questions constructed from both current related literature and golden threads from narratives I have heard, that I think are the most important ones for our discourse on Tuesday ../8/20 during OTalk at 8 pm. Can we as a community shed a modern light on this issue and find some common agreements? Please join us.


Questions

  1. Why is applying theory to practice important please?
  2. Please can you provide one example of a theory that you think is useful in occupational therapy practice?
  3. What do you think currently drives occupational therapy students to learn theory and use it in practice please?
  4. What do you think are the current barriers that occupational therapy students face learning and applying theory to practice please?
  5. How do you think student’s ability to both learn theory and apply it to practice be improved please?

#OTalk 13th October 2020 – Online groups: current occupational therapy practice

This weeks chat will be hosted by By Sam Pywell, @smileyfacehalo.

In the current world (due to COVID-19), it is possible that services where occupational therapists provide groupwork can face delivery restrictions due to social distancing, regional lockdown areas, shielding, and the personal choice a client has of wanting to engage in a group but not physically attend (perhaps due to caring for someone, or wanting to keep their bubble of exposure small).   Access to a physical space where the group and staff can socially distance may be a challenge.  Certain activities within a groupwork session e.g. messy crafts may not be possible due to difficulties with cleaning regimes.  Traditional face to face groups and groupwork may therefore not always be possible for a variety of reasons.   

Occupational therapists have the potential to deliver groupwork online depending on the individuals digital skills, access to training, equipment and access to platforms to name a few (NHS England, 2019; see @NESnmahp tweets on August 20 about “delivering digital groups”). Traditionally taught and delivered in a face to face setting, there is potential to mobilise occupational therapy groups either in part, as a whole or create a new group (e.g. to address the long covid population) online.  This could lead to additional innovate practice lead by occupational therapists for the benefit of our clients.  However, it cannot be assumed the client has the same digital access.  The clients digital skills, access to training equipment, platforms and reliable internet can all become barriers to access. It could be argued the therapists role is to explore this and enable access to the online group as well as providing the group itself. 

My interest in this area has come from delivering a module which contained groupwork, to include current practice due to COVID-19.  In order to connect pre-registration students, and colleagues who may have experienced F2F groupwork in the past, and to share best practice, the questions for this evening #OTalk are: 

1. what groups are occupational therapy staff running online now for which client groups (either as a result of COVID-19, prior to, or intend to run in the future)? 

2. what platforms are occupational therapy staff using and why? 

3. what are the barriers to running online groups? How can navigate these? 

4. what are the differences of a face to face group to a virtual group re: preparation and running? 

5. Under the NHS England (2020) and HEE (2020) definition of TECS: what would you define your group as (telehealth, telemedicine, teleconsultation etc) and why. 

6.What do you include in your risk assessment about the digital environment/ online groups (as if with F2F groupwork, you would have a risk assessment) 

By Sam Pywell, Lecturer in Occupational Therapy @ The University of Central Lancashire, Preston. #AHPsintoAction #digitalAHPs #mobilisethedigitalOT #UCLanOT @UCLanOT 

References 

NHS England (2019) A digital framework for allied health professionals https://www.england.nhs.uk/publication/a-digital-framework-for-allied-health-professionals/ 

HEE (2020) Rapid Expansion of AHP placements: Simulation and Technology Enabled Care Services (TECS) webinar  

NHS England (2020) Technology Enabled Care Services (TECS) https://www.eng

#OTalk Research 6th October 2020 – Reflexivity in Research

Welcome to this weeks #OTalk Research. I am Sarah Lawson, (@SLawsonOT) a PhD Candidate, Lecturer Practitioner at Wrexham Glyndwr University and co-author of TRAMmCPD. I am carrying out a qualitative study and one of the things I am grappling with is the concept of reflexivity. I am interested to explore the concept and hear your thoughts on this important aspect of research.

Being reflexive within our research is integral to the research process at any level. As researchers we are constructing and creating knowledge through a process of interpretation (Braun and Clarke 2019) which is based on our own values, assumptions, biases, social and cultural contexts (Creswell and Creswell 2018; Etherington 2004; Finlay and Gough 2003) . These aspects also influence our choice of research topic, paradigms, methodology and methods. Our reality is socially and personally
constructed and being reflexive is a crucial, ongoing and active process which may be challenging but is necessary to provide context, and tackle concepts such as validity, trustworthiness and reliability within our research (Clancy 2013) .

Within qualitative research researcher subjectivity through reflexivity may be considered as positive rather than negative although as with many areas within research this is often contested. To explore reflexivity further we would like to consider the following questions within this chat:

Q. 1 Can you share any experiences of reflexivity and/or the types of studies in which you have experienced reflexivity being used?
Q.2 What do you understand to be the difference between reflective practice and reflexivity?
Q. 3 How have you recorded or demonstrated reflexivity or observed it being demonstrated?
Q. 4 How has reflexivity added to your study or research you are familiar with?
Q.5 What do you find challenging about ‘reflexivity’?
Q. 6 What do you need to consider next? How will you use what you have learnt from this #OTalk?

References
Braun, V. & Clarke, V. (2019) Reflecting on Reflexive Thematic Analysis. Qualitative research in sport,
exercise and health. 11 (4) pp. 589-597.
Clancy, M. (2013) Is Reflexivity the Key to Minimising Problems of Interpretation in
Phenomenological Research? Nurse Researcher. 20 (6) pp. 12-16.
Creswell, J.W. & Creswell, D. (2018) Research Design: Qualitative, Quantitative & Mixed Methods
Approaches 5th Ed. London: Sage Publications.
Etherington, K. (2004) Becoming a Reflexive Researcher: Using Ourselves in Research. London: Jessica
Kingsley Publishers.
Finlay, L. & Gough, B. (2003) Reflexivity: A Practical Guide for Researchers in Health and Social
Sciences. Oxford: Blackwell.

#OTalk 29th September 2020 -Do OTs have a role in supporting resilience and wellbeing?

Occupational Therapists are skilled at looking at the person and a situation in a holistic manner in order to empower and support the individual to do what has meaning and purpose in their life. Through that occupation, their health and wellbeing can be improved. Terms like wellbeing gets thrown around without always having a clear sense of what we mean by them. Likewise in the last decade interest in the idea of resilience has grown- from fringe models of why some children are able to move on from difficult childhoods, to a sense of everyone’s ability to navigate life’s inevitable difficulties. 
There are a multitude of different understandings about what these terms mean. For some the idea of wellbeing and resilience can be seen as ways to put more responsibility on the individual and away from the environmental impact of struggles such as society responses to race, poverty and disability.  For this reason I use BoingBoing (see link below) definition for resilience: “Beating the odds, whilst also changing the odds”.   
It may be argued by some OTs that building resilience and wellbeing skills is the domain of psychology, but others like Dr Rachel Thibeault argue strongly that research shows that eudemonic or meaningful activities are one of the biggest influencers on an individual’s experience of whether they feel themselves to be resilient, so we can and should be within the remit of OTs. 
In addition to this I have noticed a rise in the number of OTs entering new roles that focus more on wellbeing including being part of employee wellbeing services and operating as OT coaches. In this OTalk we will explore the following questions; 
  1. – Are many OTs working in roles where they offer specific interventions around resilience or wellbeing? Are OTs supporting colleagues / workplace resilience and wellbeing?
  2. -Why do we struggle with these terms- are there better ways to describe this work?
  3. -Do OTs feel they should be doing more in this area / what is stopping them? 
  4. -What creative examples of practice are emerging? 
Boing Boing Resilience Training- source of definition above:
Dr Rachel Thibeault open access talks for CAOT on resilience:
Lyubomirsky and Porter 2010. study which explore the importance of meaningful activity in wellbeing. 

#OTalk 22nd September 2020 – Occupational Therapy and Older People

This week chat will be hosted by the Rotal College of Occupatinal Therapists Specialist Section, Older People @RCOT_OP

General deconditioning in older adults with frailty is a serious and all-too-common problem. According to the British Geriatrics Society, deconditioning includes reduced muscle strength, reduced mobility, increased falls, confusion and demotivation. Immobility can effect continence and constipation, appetite and digestion. As Occupational Therapists, the primary impact of deconditioning can be seen in reduced well-being and cognitive and physical function; in turn this impacts a person’s ability to engage in meaningful activities.

The recent #RightToRehab Twitter campaign brought to light prevalent attitudes of ageism and discrimination towards frail older people in the acute hospital setting and in the community. In the current climate of the Covid-19 pandemic, isolation and immobility has raised further discussion
around deconditioning and the right to rehab in older adults.

As a Specialist Section for Older People we’d love to continue this discussion with an Occupational perspective, and to share ideas and Top Tips for addressing this issue in hospitals and the communities where we work.

The questions for discussion in our #OTalk conversation:

1) What are people’s experiences of seeing the impact of deconditioning on levels of occupational performance in older adults?

2) How can Occupational Therapists support older adults to avoid deconditioning?

3) What intervention approaches are used, and what considerations taken into account, when assessing rehab potential in older people?

4) How is ageism a risk when considering rehab potential for deconditioned older adults?

5) In what ways do Occupational Therapy theory and practice challenge these attitudes?